Lecture 22: Human Genitalia Flashcards Preview

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Flashcards in Lecture 22: Human Genitalia Deck (44)
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Male and Female Peritoneum and Pouches

Males: 1x peritoneal pouches
1. Vesicorectal pouch: shallow, potential site for fluid to collect
Females: 2x peritoneal pouches
1. Vesicouterine pouch (anterior)
2. Pouch of Douglas/ Rectouterine pouch: deeps, extends to back of uterus--> until where vagina meets cervix. Fluid can pool --> spontaneously drain into vagina (or vagina drain into Pouch of Douglas)


State of Peritoneum in pelvic cavity

-continuous in the pelvic cavity
- located ontop of pelvic viscera
--> allows pouches to be created


Clinical relevance of Pouch of Douglas re fluid collecting

Pouch of Douglas/Rectouterine pouch is deep --> extends right behind uterus --> until where the vagina reaches the cervix
Therefore if fluid collects here (in this peritoneal pouch) --> risk of spontaneous leakage into vagina (and vice versa)


Clinical relevance of Pouch of Douglas re Surgery to remove abdominal tumour/infection

Abdominal Tumour infection
- Dont want abdominal scar from Colicysectomy --> access abdominal cavity re Pouch of Douglas/Rectouterine pouch --> Remove gallbladder


Perineal Musculature

1. Ischiocavernosa:
- attached to Ishiopubic rami + Partially to pubic symphysis
- Males: Aids erections. Females: Tenses Vagina
2. Bulbospongiosum:
- attached to Perineal body


Male Bulbospongiosum Structure and function

Forms Penis therefore --> combines/attaches at Midline Raphe --> forms Singular muscle
1. Erection
2. Ejaculation
3. Increases pressure in horizontal part of urethra --> aids Micturition (urination)


Female Bulbospongiosum Structure and Function

Forms Labia of Vagina --> Split either side of the vaginal orifice
1. Clitoral erection
2. Feelings of orgasm


Female Erectile Tissue

Located Posterior to Perineal Musculature and follows similar pattern
1. Crus of clitoris: (body of clitoris)
- attaches onto ischial pubic ramus + perineal membrane
- sweeps up to pubic symphysis --> detaches to form body of clitoris
2. Bulb of vestibule: a) Head clitoris b) surrounds vaginal orifice


Male Erectile Tissue

Located Posterior to Perineal Musculature. Follows similar pattern
Both Crus and Bulb Transfer names as go from urogenital triangle --> form penile structures
- as in males, erectile tissue detaches to become something else
1. Crus of Penis --> once detached/dorsal become Corpus cavernosa of penis (2x)
2. Bulb of penis --> becomes 1x Corpus Spongiosum + Glans Penis (which contains spongy urethra)


Vasculature of the Penis

2x Dorsal arteries + 2x Dorsal nerves of penis
1x Deep dorsal vein (b/w ^)
2x Deep (cavernous) artery
Note: Dorsal arteries, nerves + Deep dorsal veins = Below deep fascia of penis
Note: Deep cavernous artery inside Corpus cavernosa
vs Urethra inside Corpus spongiosum
Note: (3x) Superficial dorsal veins of penis = under superficial fascia
Note: ALL arteries/veins in penis = branches of Internal pudendal


Gender differences b/w vasculature of the penis

Females have the same, but all are smaller (have shorter courses)


How does the Deep dorsal vein of the penis (located b/w dorsal arteries) enter the penis?

Via deficit in peroneal membrane --> vesicular plexus around prostate and bladder



Inguinal canal/spermatic cord --> continues into the scrotum of the testes --> creates an outpouching of the skin of the abdominal wall
Scrotum = formed as testes leave the body
Therefore: inner layers of scrotum = same as spermatic cord
Blood supply: branches of Internal (& External) Pudendal arteries


Contents of the scrotum

Lower end of spermatic cord


Fascial changes in the scrotum

Abdominal Superficial Scarpa's fascia --> continuous with Superficial testicular fascia --> fat replaced by smooth muscle --> Dartos fascia
Dartos fascia (smooth muscular superficial fascia) --> continues posteriorly with Colle fascia (deep fascia of perineum)


Function of Cremaster muscle

Raise testes and scrotum.
1. Warmth
2. Protection


Embryonic formation of the scrotum

Mesenchymal cells condense --> form gubernaculum (still undifferentiated tissue) in inguinal canal --> continue into labio-scrotal swelling --> scrotum remains bound by gubernaculum
At end: Scrotum severes of its connection with the peritoneal cavity --> amkes it harder for structures to herniate through


Gubernaculum in Males and Females

Males: testes descend through inguinal canal at 7-8 months --> through gubernaculum path --> have same covering as inguinal canal
Females: Uterus is stuck to gubernaculum --> allows ovaries to remain stuck to pelvis.
In females ROUDN LIGAMENT --> goes through inguinal canal


Spermatic Cord contents Review

1. Vas Deferens
2. Testicular artery: L2 aortic brach supplies --> Testes and Epididymis
3. Testicular Veins: Pampiniform plexus:
Right Testicular vein drains to --> IVC
Left Testicular vein drains to --> L renal vein
4. Lymph vessels: (travels with arteries) Para-aortic nodes at root of testicular artery L2
5. Autonomic Nerves: Sympathetic artery from testicular plexus


Origins of additional arteries in Spermatic cord

Inferior epigastric --> Cremasteric artery
Inferior vesical --> Artery of Vas Deferens
Genital branch of Genitofemoral nerve --> innervates cremaster muscle and skin of scrotum



Create sperm (spermatogenesis)
Tunia Albuiginea: Tough outer fibrous capsule
Made up of Lobules --> each lobule contains 1-2 Seminiferous Tubules --> open into Rete Testis --> Efferent Tubules --> Epididymis(sperm storage) --> Vas deferens


Temperature of testes

3 degree cooler < abdomen
Cooling is aided by:
1. Dartos fascia (abd. Scarpa fascia fat replaced with muscle --> decreased insulation)
2. Cremaster muscle (allows testes to hang outside)
3. Heat exchange b/w artery and veins


Male Internal Genitalia attaching onto epidiymis

Vas deferens --> Ampulla(sperm) --+seminal vesicles (liquid) --> Ejaculatory duct --+urethra--> Prostatic urethra


Vas deferens

Muscular tube
Inside spermatic cord --> therefore Travels within Inguinal canal
Note: there is a vas deferens equivalent in females


Vas Deferen's course to the prostate

(DIR) Starts LATERAL to Inferior Epigastric artery --> Runs SUPERIORLY to External iliac vessels (passing medially towards prostate) --> Vas deferens runs SUPERIORLY to ureter(urine) --> Joins seminal vesicles --> forms ejaculatory duct which enters prostate


Seminal vesicles

Coiled:5cm long --> Uncoiled 10-15cm
Secrete Liquid component of ejaculate (fluid + fructose)
Note: Fructose = sugar = energy for sperm to make journey to egg
Seminal vesicle location: Posterior to bladder, Superior to prostate


What are the main components of the prostate gland(s)?

1. Ejaculatory duct
2. Prostatic urethra


Prostate gland

Inferior to bladder
Ejaculatory duct + prostatic urethra
1. Proteolytic enzymes
2. Acid phosphotase
All arteries supplying are branches of Internal Illiac artery:
1. Internal pudendal
2. Middle rectal
3. Inferior vesicle
Veins of prostate gland:
Deep dorsal vein of penis --> vesicular plexus (good blood supply)--> Internal Illiac


Prostatic ligaments

Levator Prostate: "levator" = levitate = lift
Located inferior to prostate but anterior to urogenital diaphragm
Function: support prostate


Prostatic enlargement

Enlargement can be:
- All or partial
- Benign or malignant
Seen commonly in DR as Benign enlargement in 50+ yr old males
1. Postatic enlargement (esp of median lobe) --> Herniation superiorly through sphincter from bladder -->bladder's internal sphincter vesicae unable to close properly --> urinary incontinence
2. Pocket created posteriorly in bladder near sphincter --> pool with fluid --> consistent pressure on sphincter --> continuous feeling of needing to pee